CAJ | 학술논문

目的：通过对比腹腔镜与开腹远端胃癌D2根治术的疗效及安全性，探讨腹腔镜辅助远端胃癌D2根治术的临床价值。方法221例行远端胃癌D2根治术患者，分为两组。其中腹腔镜组115例，开腹组106例，对两组手术时间、术中出血量、术后排气时间、首次进流质时间、淋巴结清扫数目、术后住院天数、并发症进行比较。结果腹腔镜组手术时间、淋巴结清扫数与开腹组差异无统计学意义(P>0.05)，而腹腔镜组术中出血量少，术后肛门排气时间早，首次进流质时间早，术后住院时间短，并发症发生率低(P<0.05)。结论腹腔镜辅助远端胃癌D2根治术具有创伤小、出血少、术后恢复快和并发症少等优点，近期疗效与开腹手术相当，安全可行，值得临床推广。
목적：통과대비복강경여개복원단위암D2근치술적료효급안전성，탐토복강경보조원단위암D2근치술적림상개치。방법221례행원단위암D2근치술환자，분위량조。기중복강경조115례，개복조106례，대량조수술시간、술중출혈량、술후배기시간、수차진류질시간、림파결청소수목、술후주원천수、병발증진행비교。결과복강경조수술시간、림파결청소수여개복조차이무통계학의의(P>0.05)，이복강경조술중출혈량소，술후항문배기시간조，수차진류질시간조，술후주원시간단，병발증발생솔저(P<0.05)。결론복강경보조원단위암D2근치술구유창상소、출혈소、술후회복쾌화병발증소등우점，근기료효여개복수술상당，안전가행，치득림상추엄。
Objective To explore the clinical value of laparoscope assisted D2 radical gastrectomy for distal gastric cancer by comparing the curative effects and safety of laparoscope and laparotomy D2 radical gastrectomy. Methods A total of 221 cases of distal gastric cancer underwent D2 radical gastrectomy were divided into two groups as laparoscope group (n=115) and laparotomy group (n=106). The operation time, intraoperative bleeding volume, postoperative exhaust time, first time of liquid diet, number of lymph node cleaning, postoperative hospital stays, and complications were compared between the two groups. Results There were no significant differences of operation time, number of lymph node cleaning, and complications between the laparoscope group and laparotomy group (P>0.05). However, the laparoscope group had fewer intraoperative bleeding volumes, earlier postoperative anal exhaust time, earlier first time of liquid diet, shorter postoperative hospital stays and lower incidence of complications (P<0.05). Conclusion Laparoscope assisted D2 radical gastrectomy in the treatment of distal gastric cancer has small trauma, few bleeding, quick recovery and less complications. The recent curative effect is similar as that of laparotomy, and the treatment is safe and feasible, and worthy of clinical promotion.